International Urogynecology Journal

, Volume 26, Issue 10, pp 1483–1488 | Cite as

Factors associated with fecal incontinence in a nationally representative sample of diabetic women

  • Maria De La Luz NietoEmail author
  • Jennifer M. Wu
  • Catherine Matthews
  • William E. Whitehead
  • Alayne D. Markland
Original Article


Introduction and hypothesis

Fecal incontinence (FI) is a debilitating condition that significantly affects quality of life, and has been associated with multiple risk factors. Our goal was to assess the prevalence of FI among diabetic women and evaluate factors associated with FI in this population.


The National Health and Nutrition Examination Survey (NHANES) from 2005 to 2010 was used to evaluate women with diabetes mellitus and FI. FI was defined as involuntary loss of mucus, liquid, or solid stool at least monthly. Severity was evaluated using the Fecal Incontinence Severity Index. Potential risk factors associated with FI were explored with weighted chi-squared statistics. Variables associated with FI in multivariable logistic regression analysis are reported with odds ratios (OR) and 95 % confidence intervals (95 % CI).


Among 7,039 women, 13.6 % were diabetic, and 18.1 % of diabetic women reported FI compared to 8.4 % in the overall NHANES population (p < .001). In diabetic women, FI was associated with advancing age (OR 1.3, 95 % CI 1.1 – 1.5), depression (OR 2.0 95 % CI 0.9 – 4.5), poorer health status (OR 1.9, 95 % CI 1.2 – 3.1), urinary incontinence (OR 3.5, 95 % CI 2.1 – 5.9) and bowel movement frequency of ≥21/week (OR 4.9, 95 % CI 2.3 – 10.6) in a multivariable logistic regression model adjusted for race, education level, BMI, comorbidities, prior hysterectomy, and stool consistency.


FI affects one in five diabetic women and is strongly associated with high bowel movement frequency, a possible important modifiable factor that should be investigated further in prospective studies.


Diabetes Fecal incontinence Urinary incontinence Health status 


Conflicts of Interest

J.M. Wu: Proctor and Gamble Consultant

C. Matthews: Pelvalon and Boston Scientific Consultant

W.E. Whitehead: Salix Pharmaceuticals, Taxeda Pharmaceuticals, Rome Pharmaceuticals Consultant


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Copyright information

© The International Urogynecological Association 2015

Authors and Affiliations

  • Maria De La Luz Nieto
    • 1
    Email author
  • Jennifer M. Wu
    • 1
    • 2
  • Catherine Matthews
    • 1
  • William E. Whitehead
    • 3
  • Alayne D. Markland
    • 4
    • 5
  1. 1.Division of Urogynecology, Department of Ob/GynUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Center for Women’s Health Research, Center for Aging and HealthUniversity of North CarolinaChapel HillUSA
  3. 3.Division of Gastroenterology and HepatologyUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Birmingham VAMC GRECCBirminghamUSA
  5. 5.Department of Medicine, Division of Gerontology, Geriatrics, and Palliative CareThe University of Alabama at BirminghamBirminghamUSA

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